ArticleJAMA surgery2025
Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest.
Article in JAMA surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Transport and destination hospital for patients with suspected multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Resuscitative thoracotomy in traumatic cardiac arrest : Multisociety consensus recommendations for settings with a low prevalence of penetrating injuries.Wiener klinische Wochenschrift · 2026Pooled it
- Extracorporeal cardiopulmonary resuscitation in patients with traumatic cardiac arrest during the acute phase following injury: a comprehensive systematic review and meta-analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- Epidemiology of trauma deaths across a mature regional trauma system: patterns of prehospital and in-hospital fatalities.The British journal of surgery · 2026Article
- Pericardial Decompression for Acute Traumatic Cardiac Tamponade-Pearls and Clamshells.Emergency medicine Australasia : EMA · 2026Article
- Timing and outcomes of out-of-hospital traumatic cardiac arrest: results of a multicentre, retrospective cohort study.Resuscitation plus · 2026Article
- Reporting of Utstein-recommended variables in prehospital traumatic cardiac arrest: a scoping review.BMC emergency medicine · 2026Article
- The impact of advanced pre-hospital interventions on scene time.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Community Code Blue: The Sydney Jewish Community's Medical Preparations and Response to the Bondi Beach Terror Attack of December 2025.The Medical journal of Australia · 2026Article
- Reversible causes of death and the potential benefit of invasive emergency techniques in paediatric and adolescent trauma: a 12-years retrospective forensic analysis.BMC emergency medicine · 2026Observational
- An observational study of pre-hospital central venous access for patients with haemorrhagic shock due to major trauma.Anaesthesia · 2026Observational
- 2025 Practice-changing articles in trauma, emergency general surgery, pediatric trauma, and surgical critical care: an EAST narrative review.Trauma surgery & acute care open · 2026Review
- Article
- Improving decision-making for prehospital Resuscitative Thoracotomy in traumatic cardiac arrest: a data-driven approach.Critical care (London, England) · 2025Review
- Unlocking survival in traumatic cardiac arrest: global insights, innovations, and unmet needs.Critical care (London, England) · 2025Review
- Outcomes and guideline adherence for emergency department thoracotomy: a single-center experience in Saudi Arabia.International journal of emergency medicine · 2025Article
- Development of novel thoracic retractor for resuscitative thoracotomy.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Nordic physician-staffed prehospital services - organisation and preparedness for major emergency surgical procedures.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Successful treatment of recurrent traumatic cardiac arrest due to splenic rupture in trauma resuscitation unit: a case report.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Traumatic cardiac arrest (TCA) presents a critical challenge in trauma care, often occurring rapidly after injury before effective interventions are available. Objective: To evaluate the association of prehospital resuscitative thoracotomy with survival outcomes for TCA. Design, Setting, and Participants: This retrospective cohort study examined all cases of prehospital resuscitative thoracotomy for TCA in London from January 1999 to December 2019. Data were analyzed from July 2022 to July 2023. Exposure: Prehospital resuscitative thoracotomy for TCA. Main Outcomes and Measures: The primary outcome was survival to hospital discharge. Secondary outcomes included survival to hospital admission and neurological status at discharge. Results: Prehospital resuscitative thoracotomy was undertaken in 601 patients with out-of-hospital TCA. The median (IQR) age was 25 (20-37) years; 538 (89.5%) were male and 63 (10.5%) female. A total of 529 patients (88.0%) had a penetrating mechanism of injury. TCA occurred at a median (IQR) of 12 (6-22) minutes after the emergency call, with 491 arrests (81.7%) before the advanced trauma team's arrival. TCA was the result of cardiac tamponade (105 patients, 17.5%), exsanguination (418 patients, 69.6%), and exsanguination combined with cardiac tamponade (72 patients, 12.0%). Thirty patients (5.0%) survived to hospital discharge, with a favorable neurological outcome observed in 23 survivors (76.6%). Survival varied significantly with the cause of TCA: 22 of 105 patients (21%) with cardiac tamponade, 8 of 418 patients (1.9%) with exsanguination, and none of the 72 patients with combined or other pathologies survived. There were no survivors beyond 15 minutes of TCA for cardiac tamponade and 5 minutes after exsanguination. Multivariable analysis revealed that the cause of TCA (adjusted odds ratio [aOR], 21.1; 95% CI, 8.1-54.7; P < .001), duration of TCA (aOR, 20.9; 95% CI, 4.4-100.6, P < .001), and absence of the need for internal cardiac massage (AOR, 0.2; 95% CI, 0.06-0.5; P = .001) were independently associated with survival. Conclusions and Relevance: TCA occurs soon after injury, with only a brief window available for effective intervention. This study found that resuscitative thoracotomy is feasible in a mature, physician-led, urban prehospital system and is associated with improved survival for patients with out-of-hospital TCA, particularly when caused by cardiac tamponade, in situations where other treatment options are limited.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.